Qualitative Assessment of a Smartphone-Based Mobile Health Tool to Guide Diarrhea Management in Bangladesh.
Qualitative Assessment of a Smartphone-Based Mobile Health Tool to Guide Diarrhea Management in Bangladesh.
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DOI：
10.4269/ajtmh.23-0444
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发表时间：
2024-01-03
期刊：
影响因子：
--
通讯作者：
Leung DT
中科院分区：
文献类型：
--
作者：
Biswas D;Asadullah A;Khan SH;Khan ZH;Islam MT;Khan AI;Qadri F;Nelson EJ;Watt MH;Leung DT
腹泻病是全世界儿童发病和死亡的一个主要原因，也是造成抗菌素耐药性的一个重要因素。在缺乏实验室诊断来确定腹泻病因的情况下，电子临床决策支持工具可以帮助医生为腹泻儿童做出明智的治疗决策。在孟加拉国，我们评估了将电子腹泻病因预测算法（DEP工具）嵌入补液计算器的可行性和可接受性，该工具旨在帮助医生管理腹泻儿童，包括决定抗生素的使用。一组孟加拉国人类学家对孟加拉国三家公立医院的医生（N = 13）进行了深入访谈，了解他们在试点试验中使用该工具的经验。医生对DEP工具表达了积极的看法。参与者认为该工具简单易用，在收集和输入患者临床数据方面有结构化的指导。该工具的显著优势如下：方案的标准化，临床决策的效率，临床实践的改善。与会者还注意到可能限制该工具广泛影响的障碍，包括医生不愿使用电子工具进行临床决策，在负担过重的医疗机构增加工作，无法获得智能手机，以及患者对抗生素的偏好。我们得出结论，电子临床决策支持工具是改善腹泻管理和抗生素管理的有希望的方法。未来的方向包括开发和实施这种工具，在资源匮乏的环境中，家庭可能首先寻求儿童腹泻的护理。
Diarrheal diseases are a major cause of morbidity and mortality in children worldwide and a significant contributor to antimicrobial resistance. In the absence of laboratory diagnostics to establish diarrhea etiology, electronic clinical decision support tools can help physicians make informed treatment decisions for children with diarrhea. In Bangladesh, we assessed the feasibility and acceptability of an electronic Diarrhea Etiology Prediction algorithm (DEP tool) embedded into a rehydration calculator, which was designed to help physicians manage children with diarrhea, including decisions on antibiotic use. A team of Bangladeshi anthropologists conducted in-depth interviews with physicians (N = 13) in three public hospitals in Bangladesh about their experience using the tool in the context of a pilot trial. Physicians expressed positive opinions of the DEP tool. Participants perceived the tool to be simple and easy to use, with structured guidance on collecting and entering clinical data from patients. Significant strengths of the tool were as follows: standardization of protocol, efficiency of clinical decision-making, and improved clinical practice. Participants also noted barriers that might restrict the widespread impact of the tool, including physicians’ reluctance to use an electronic tool for clinical decision-making, increasing work in overburdened healthcare settings, unavailability of a smartphone, and patients’ preferences for antibiotics. We conclude that an electronic clinical decision support tool is a promising method for improving diarrheal management and antibiotic stewardship. Future directions include developing and implementing such a tool for informal healthcare physicians in low-resource settings, where families may first seek care for pediatric diarrhea.
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DOI：
10.1093/cid/ciaa1545
发表时间：
2021-08-02
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Pavlinac PB;Platts-Mills JA;Tickell KD;Liu J;Juma J;Kabir F;Nkeze J;Okoi C;Operario DJ;Uddin J;Ahmed S;Alonso PL;Antonio M;Becker SM;Breiman RF;Faruque ASG;Fields B;Gratz J;Haque R;Hossain A;Hossain MJ;Jarju S;Qamar F;Iqbal NT;Kwambana B;Mandomando I;McMurry TL;Ochieng C;Ochieng JB;Ochieng M;Onyango C;Panchalingam S;Kalam A;Aziz F;Qureshi S;Ramamurthy T;Roberts JH;Saha D;Sow SO;Stroup SE;Sur D;Tamboura B;Taniuchi M;Tennant SM;Roose A;Toema D;Wu Y;Zaidi A;Nataro JP;Levine MM;Houpt ER;Kotloff KL
通讯作者：
Kotloff KL
DOI：
10.1007/978-1-4419-0981-7_6
发表时间：
2010-01-01
期刊：
HOT TOPICS IN INFECTION AND IMMUNITY IN CHILDREN VI
影响因子：
--
作者：
English, B. Keith;Gaur, Aditya H.
通讯作者：
Gaur, Aditya H.
影响因子：
3.8
作者：
Haque, Farhana;Ball, Robyn L.;Nelson, Eric Jorge
通讯作者：
Nelson, Eric Jorge
影响因子：
--
作者：
Leech, Nancy L.;Onwuegbuzie, Anthony J.
通讯作者：
Onwuegbuzie, Anthony J.
影响因子：
4.4
作者：
Mitchell, Marc;Getchell, Maya;Hedt-Gauthier, Bethany
通讯作者：
Hedt-Gauthier, Bethany